scholarly journals Features of minimally invasive ligamentotomy of the thumb A1 pulley (our experience)

2021 ◽  
Vol 24 (2) ◽  
pp. 64-73
Author(s):  
A. V. Zhigalo ◽  
V. V. Pochtenko ◽  
V. V. Morozov ◽  
P. A. Berezin ◽  
M. A. Zhogina ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Average Length ◽  
Outpatient Setting ◽  
Trigger Finger ◽  
Safe Procedure ◽  
Results Of Treatment ◽  
Orthopedic Surgeons ◽  
Lower Treatment ◽  
Stenosing Tenosynovitis ◽  
A1 Pulley

Objective. Stenosing tenosynovitis (Nott’s disease, "trigger finger") is one of the most common pathologies of the hand which hand surgeons and orthopedic surgeons have to deal with. A variety of conservative methods are used to treat “trigger finger", including individual splinting and corticosteroid injections. Surgical treatment consists of dissection of the A1 pulley. Traditionally, the operation starts with a small incision. However, in recent years, a number of articles have appeared that report that percutaneous ligamentotomy on II-V fingers is a safe and effective alternative to an open surgery. Due to anatomical features, some authors do not recommend performing a percutaneous ligamentotomy on the thumb, fearing the damage it can cause to the digital nerves.The purpose of this research is to show that the minimally invasive needle ligamentotomy of the thumb A1 pulley is a safe procedure and to conduct the approbation of the offered method.Material and methods. The research consisted of two parts - anatomical and clinical. In the anatomical part of the research (8 upper extremities of 4 unfixed corpses), we proposed the safe accesses in order to conduct percutaneous ligamentotomy of the thumb A1 pulley.In the clinical part of the study we tested a minimally invasive ligamentotomy and analysed the results of treatment in 109 patients with stenosing tenosynovitis of the thumb II-IV stage by Green aged from 28 to 80. All patients received minimally invasive ligamentotomy of the A1 pulley with 18g needle under local anaesthesia (120 surgeries). Average length of the operation was several minutes. All procedures were performed outpatiently. Evaluation of the results of treatment was performed using the Visual Analog Scale (VAS) and Gilberts questionnaire. The observation period was from 12 months up to 24 months.The results. In most cases both clinical and esthetical results were excellent. It was possible to eliminate the “trigger” of the finger intraoperatively for all patients. However, 6 (5.5%) patients complained about the presence of residual clicks due to incomplete dissection of the ligament at the control examination a week later. Percutaneous ligamentotomy was conducted again on all patients with successful outcomes. No recurrence of the disease was noted. 17% of patients tend to complain about pain in the A1 pulley localization during the first week after the operation.Conclusion. The empirical findings prove the efficiency and safety of percutaneous ligamentotomy of the thumb A1 pulley. One of the merits of this technique is a lower risk of postoperative complications and lower treatment expenses. This technique can be successfully used in the practice of hand surgeons in the outpatient setting that have the experience with the conduction of open operations.

Endoscopic Trigger Finger Release: Surgical Technique

2018 ◽  
Vol 23 (01) ◽  
pp. 158-161
Author(s):  
Scott F.M. Duncan ◽  
Ryosuke Kakinoki ◽  
Ross Dunbar
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Skin Incision ◽  
Endoscopic Technique ◽  
Trigger Finger ◽  
Surgical Approaches ◽  
Flexor Tendons ◽  
Stenosing Tenosynovitis ◽  
A1 Pulley

Numerous surgical approaches have been described for treating patients suffering with stenosing tenosynovitis. The usual surgical descriptions differ mainly by the type of skin incision utilized. The goal of surgery is to completely release the A1 pulley, thereby allowing unimpeded motion of the flexor tendons. We describe a minimally invasive endoscopic technique to address this condition in the fingers.

scholarly journals Results of percutaneous release of stenosing tenosynovitis (trigger finger) using hypodermic needle

2019 ◽  
Vol 5 (4) ◽  
pp. 578
Author(s):  
Shiv Kumar ◽  
Khalid Muzzafar ◽  
Irfan Tasaduq ◽  
Arpan Bijyal
Keyword(s):  
Hand Function ◽  
Trigger Finger ◽  
Hypodermic Needle ◽  
Common Condition ◽  
Open Release ◽  
Percutaneous Release ◽  
Stenosing Tenosynovitis ◽  
Level Hospital ◽  
A1 Pulley

<p class="abstract"><strong>Background:</strong> Stenosing tenosynovitis or trigger finger is a common condition affecting finger function, which can lead to disability in hand function. Treatment in form of conservative can be helpful in early stages, however later stages and chronic triggering needs release of A1 pulley either by open or percutaneous methods. The aim of this study was to find the results of percutaneous release of trigger finger with 18 guage needle.</p><p class="abstract"><strong>Methods:</strong> 43 digits in 36 patients were enrolled for this prospective study in a district level hospital over a 2 year period. Release was done under local anaesthesia using 18 guage needle percutaneously. Follow up was done upto 6 months. Final scoring was done at 6 months using Quinell’s criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> We had 81.39% (35 out of 43) excellent to good results. 19.61% (8) needed open release. We had no neurovascular injury or infection in our series.</p><p class="abstract"><strong>Conclusions:</strong> Percutaneous release by 18 guage needle is safe and effective treatment for trigger finger without much complication.</p>

scholarly journals The Management of Trigger Finger: A 5-Year Retrospective Review

2021 ◽  
Vol 4 (2) ◽  
Keyword(s):  
General Population ◽  
Retrospective Review ◽  
Flexor Tendon ◽  
Age Of Onset ◽  
Ring Finger ◽  
Trigger Finger ◽  
Dominant Hand ◽  
Increased Risk ◽  
Stenosing Tenosynovitis ◽  
A1 Pulley

Stenosing tenosynovitis, generally known as Trigger Finger (TF), is a common hand disorder characterized by pain and locking of the affected digit, which is often found on the dominant hand [1- 3]. This locking occurs when swelling or thickening of the flexor tendon restricts its ability to glide through the A1 pulley during flexion or extension [4, 5]. The general population has a two percent lifetime risk of developing trigger finger, with an average age of onset of 50 years [6, 7]. Women are affected up to six times more than men and diabetics have an increased risk of 10% [8, 9]. Although all digits are susceptible, evidence has shown the ring finger and thumb to be the most affected [10].

scholarly journals Trigger finger due to phalangeal osteochondroma of an adult: A case report

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902096999
Author(s):  
Hoi Young Kwon ◽  
Hong Je Kang
Keyword(s):  
Pediatric Patients ◽  
Proximal Phalanx ◽  
Middle Finger ◽  
Trigger Finger ◽  
X Rays ◽  
Solitary Osteochondroma ◽  
Stenosing Tenosynovitis ◽  
Left Middle ◽  
A1 Pulley ◽  
Rule Out

Trigger finger is stenosing tenosynovitis that occurs in A1 pulley. It usually occurs idiopathically in patients’ 40s and 50s. On the other hand, pediatric trigger finger usually occurs before 8 years old in pediatric patients. Even though being rare, a tumor occurred in the soft tissue or bone near flexor tendons can cause a trigger finger. Trigger finger due to osteochondroma is very rare. Furthermore, most cases of trigger finger due to osteochondroma occur in pediatric patients with hereditary multiple osteochondromatosis (HMO). The authors report this case of a trigger finger caused by a solitary osteochondroma that occurred in the proximal portion of the proximal phalanx of the left middle finger, of a 21-year-old patient. The symptoms were relieved after excision of the osteochondroma. If a patient with unusual demographics visits, the cause of trigger finger may not be idiopathic. Evaluation methods such as x-rays and ultrasonography can be helpful to rule out other causes, such as tumors.

scholarly journals Stable Low-Grade Degenerative Spondylolisthesis Does Not Compromise Clinical Outcome of Minimally Invasive Tubular Decompression in Patients with Spinal Stenosis

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1270
Author(s):  
Morsi Khashan ◽  
Khalil Salame ◽  
Dror Ofir ◽  
Zvi Lidar ◽  
Gilad J. Regev
Keyword(s):  
Clinical Outcome ◽  
Minimally Invasive ◽  
Spinal Stenosis ◽  
Average Length ◽  
Degenerative Spondylolisthesis ◽  
Leg Pain ◽  
P Value ◽  
Low Grade ◽  
Safe Procedure ◽  
Significant Difference

Background and Objectives: In recent literature, the routine addition of arthrodesis to decompression for lumbar spinal stenosis (LSS) with concomitant stable low-grade degenerative spondylolisthesis remains controversial. The purpose of this study is to compare the clinical outcome, complication and re-operation rates following minimally invasive (MIS) tubular decompression without arthrodesis in patients suffering from LSS with or without concomitant stable low-grade degenerative spondylolisthesis. Materials and Methods: This study is a retrospective review of prospectively collected data. Ninety-six consecutive patients who underwent elective MIS lumbar decompression with a mean follow-up of 27.5 months were included in the study. The spondylolisthesis (S) group comprised 53 patients who suffered from LSS with stable degenerative spondylolisthesis, and the control (N) group included 43 patients suffering from LSS without spondylolisthesis. Outcome measures included complications and revision surgery rates. Pre- and post-operative visual analog scale (VAS) for both back and leg pain was analyzed, and the Oswestry Disability Index (ODI) was used to evaluate functional outcome. Results: The two groups were comparable in most demographic and preoperative variables. VAS for back and leg pain improved significantly following surgery in both groups. Both groups showed significant improvement in their ODI scores, at one and two years postoperatively. The average length of hospital stay was significantly higher in patients with spondylolisthesis (p-value< 0.01). There was no significant difference between the groups in terms of post-operative complications rates or re-operation rates. Conclusions: Our results indicate that MIS tubular decompression may be an effective and safe procedure for patients suffering from LSS, with or without degenerative stable spondylolisthesis.

Lumbar periarticular cysts of arcorray joint

2020 ◽  
pp. 47-57
Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter
Keyword(s):  
Minimally Invasive ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Lumbar Region ◽  
Results Of Treatment ◽  
Invasive Method ◽  
Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

The Hallux Metatarsophalangeal Capsule: An Anatomic Study With Respect to Percutaneous Hallux Valgus Correction

2021 ◽  
pp. 107110072110272
Author(s):  
Kenneth M. Chin ◽  
Nicholas S. Richardson ◽  
John T. Campbell ◽  
Clifford L. Jeng ◽  
Matthew W. Christian ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Metatarsal Head ◽  
Cadaveric Study ◽  
Anatomic Study ◽  
Orthopedic Surgeons ◽  
Popular Knowledge ◽  
Fresh Frozen ◽  
The Mean ◽  
Anatomic Relationship

Background: Minimally invasive surgery for the treatment of hallux valgus deformities has become increasingly popular. Knowledge of the location of the hallux metatarsophalangeal (MTP) proximal capsular origin on the metatarsal neck is essential for surgeons in planning and executing extracapsular corrective osteotomies. A cadaveric study was undertaken to further study this anatomic relationship. Methods: Ten nonpaired fresh-frozen frozen cadaveric specimens were used for this study. Careful dissection was performed, and the capsular origin of the hallux MTP joint was measured from the central portion of the metatarsal head in the medial, lateral, dorsal, plantarmedial, and plantarlateral dimensions. Results: The ten specimens had a mean age of 77 years, with 5 female and 5 male. The mean distances from the central hallux metatarsal head to the MTP capsular origin were 15.2 mm dorsally, 8.4 mm medially, 9.6 mm laterally, 19.3 mm plantarmedially, and 21.0 mm plantarlaterally. Conclusion: The MTP capsular origin at the hallux metatarsal varies at different anatomic positions. Knowledge of this capsular anatomy is critical for orthopedic surgeons when planning and performing minimally invasive distal metatarsal osteotomies for the correction of hallux valgus. Type of Study: Cadaveric Study.

scholarly journals Recoup From Home? Comparison of Relative Cost Savings for ACDF, Lumbar Discectomy, and Short Segment Fusion Performed in the Inpatient Versus Outpatient Setting

2021 ◽  
Vol 11 (1_suppl) ◽  
pp. 56S-65S
Author(s):  
Christopher M. Mikhail ◽  
Murray Echt ◽  
Stephen R. Selverian ◽  
Samuel K. Cho
Keyword(s):  
Minimally Invasive ◽  
Cost Savings ◽  
Outpatient Setting ◽  
Lumbar Discectomy ◽  
Minimally Invasive Techniques ◽  
Relative Cost ◽  
Short Segment ◽  
Lumbar Microdiscectomy ◽  
Same Day Discharge ◽  
Invasive Techniques

Study Design: Broad narrative review. Objective: To review and summarize the current literature on the cost efficacy of performing ACDF, lumbar discectomy and short segment fusions of the lumbar spine performed in the outpatient setting. Methods: A thorough review of peer- reviewed literature was performed on the relative cost-savings, as well as guidelines, outcomes, and indications for successfully implementing outpatient protocols for routine spine procedures. Results: Primary elective 1-2 level ACDF can be safely performed in most patient populations with a higher patient satisfaction rate and no significant difference in 90-day reoperations and readmission rates, and a savings of 4000 to 41 305 USD per case. Lumbar discectomy performed through minimally invasive techniques has decreased recovery times with similar patient outcomes to open procedures. Performing lumbar microdiscectomy in the outpatient setting is safe, cheaper by as much as 12 934 USD per case and has better or equivalent outcomes to their inpatient counterparts. Unlike ACDF and lumbar microdiscectomy, short segment fusions are rarely performed in ASCs. However, with the advent of minimally invasive techniques paired with improved pain control, same-day discharge after lumbar fusion has limited clinical data but appears to have potential cost-savings up to 65-70% by reducing admissions. Conclusion: Performing ACDF, lumbar discectomy and short segment fusions in the outpatient setting is a safe and effective way of reducing cost in select patient populations.

Management of Stenosing Tenosynovitis (trigger finger) with Ayurved- A case study

2020 ◽  
Vol 8 (01) ◽  
Author(s):  
Sunil D. Tagalpallewar
Keyword(s):  
Middle Finger ◽  
Tendon Sheath ◽  
Finger Joint ◽  
Trigger Finger ◽  
Complete Relief ◽  
Painful Condition ◽  
Flexor Tendons ◽  
Stenosing Tenosynovitis ◽  
Ayurvedic Treatment

Trigger finger is a painful condition that makes your fingers or thumb catch or lock when you bend them. It can affect any finger, or more than one. You might hear it called stenosing tenosynovitis. Most of the time, it comes from a repeated movement or forceful use of your finger or thumb. It can also happen due to inflammation. Local swelling from inflammation or scarring of the tendon sheath (tenosynovium) around the flexor tendons causes trigger finger. These tendons normally pull the affected digit inward toward the palm (flexion). When they are inflamed, they tend to catch where they normally slide through the tendon sheath. A 62 year old patient visited OPD. He was having symptoms on right hand middle finger and side finger.  He has difficulty in folding joint and if he fold finger joint he was unable to straight the joint. There was no relief aftermodern medicine. So he wishes to start Ayurvedic treatment. As per ayurved it is sandhi snayugat vata vikar. So considering this diagnosis, ksheerbala 101-  2 capsules tds were prescribed. Patient got complete relief after 3 months.

scholarly journals Result of using a minimally invasive method of surgical treatment of purulent-necrotic complications in a patient with diabetic foot syndrome

2020 ◽  
Vol 39 (3) ◽  
pp. 60-64
Author(s):  
Sergey Y. Ivanusa ◽  
Boris V. Risman ◽  
Andrey V. Yanishevskiy
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Diabetic Foot ◽  
Pain Syndrome ◽  
Diabetic Foot Syndrome ◽  
Military Medical Academy ◽  
Results Of Treatment ◽  
Medical Academy ◽  
Invasive Method ◽  
Short Time

The article presents an analysis of the results of treatment of a patient with purulent-necrotic complications of diabetic foot syndrome, who, in the framework of surgical treatment, used a minimally invasive method of treatment of purulent-necrotic complications of diabetic foot syndrome, developed at the departments of general surgery and normal anatomy of the S.M. Kirov Military Medical Academy. The effectiveness of the developed method has been demonstrated, which makes it possible to sanitize the purulent cavity in a short time, stop pain syndrome and restore the support ability of the foot (4 figs, 1 table, bibliography: 7 refs).

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